What is a fistula-in-ano?
A fistula-in-ano, known as भगंदर in Marathi, is a thin tunnel that forms between the inside of the anal canal and the skin outside, near the anus. It usually starts after an abscess (a pus-filled boil) near the anus. The abscess bursts or is drained, but a small track remains. This track keeps leaking.
Common signs of fistula
- A small opening or wound near the anus that does not heal
- Pus, blood or watery discharge that stains underwear
- Pain or swelling that comes and goes
- Itching and irritation of the skin around the anus
- Sometimes fever when pus collects again
Many people think this is piles. It is a different problem and needs a different treatment.
Why does a fistula need surgery?
Medicines such as antibiotics can reduce pain and infection for a while. But the tunnel usually stays. Over time it can form branches and become more complex. That is why most fistulas need a procedure to close or open the track so that it can heal from inside. Waiting too long can make treatment more difficult.
How is a fistula checked?
The surgeon will examine the area gently, often with a proctoscope. In some patients, especially if the fistula is deep, has come back, or has more than one opening, an MRI fistulogram may be advised. This scan shows the exact path of the tunnel and its relation to the sphincter (the muscle that controls the bowel). This helps plan a safer operation.
Treatment options
Laser fistula closure
In this method, a thin laser fibre is passed into the tunnel. The laser energy seals the track from inside. There is no large cut. For suitable fistulas, this may mean less pain and a quicker return to daily work. It aims to protect the sphincter muscle.
Fistulotomy
In a simple, low fistula, the surgeon may open the tunnel along its length so it heals from the bottom up. This is a well-established method. The wound needs regular dressing and sitz baths until it heals.
The choice depends on the type of fistula, its depth and your overall health. Some fistulas need more than one procedure. Fistulas can recur, and results vary from patient to patient. Your surgeon will explain the options, the benefits and the risks before you decide.
After the procedure
Keep the area clean. Take sitz baths as advised. Eat soft, high-fibre food and drink enough water so stools stay soft. Come for every follow-up visit. Tell us early if you notice fever, increasing pain or fresh discharge.
Call or WhatsApp 7769961919 to book an examination. Cashless treatment is available with many insurance companies.
Advantages of treatment
- Careful examination to plan the right procedure
- Laser fistula closure for suitable cases
- MRI fistulogram advised when needed
- Aim to protect bowel-control muscle
- Cashless treatment with many insurers